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North Carolina: You've gotta be kidding me.

Fri, 06/12/2015 - 12:22pm

David K. Jones is an assistant professor at the Boston University School of Public Health. Nicholas Bagley is an assistant professor of law at the University of Michigan. Over the past week or so, they and their colleagues have posted a series of 3 pieces detailing the King v. Burwell response situation across 5 states currently at risk of losing their subsidies. The first part covered Florida. The second covered my home state of Michigan along with New Hampshire. The final piece looked at North Carolina and Utah.

The whole series is excellent and worth a read. However, there's one particular bit in the North Carolina section which caused me to #FacePalm so hard I may have caused a concussion, and my eyeballs to roll so far back in my head that I may need an ophthalmologist more than Luis Lang:

By the time McCrory took office in early 2012, Republican opposition to an exchange had hardened. Within months, McCrory had signed Senate Bill 4, which states unequivocally that “[n]o department, agency, or institution of this State shall take any actions not authorized by the General Assembly toward the formation of a State-run Health Benefit Exchange.” Senate Bill 4 also provides that North Carolina will not expand its Medicaid program under the ACA.

Given the political climate and Senate Bill 4’s prohibition, very little work has been done to plan for an adverse decision in King. As late as March 2015, many legislators were unaware that subsidies were at risk. Awareness of the issue has percolated within the legislature following oral arguments in King, but legislators have not publicly discussed contingency plans. As Governor McCrory recently said, “There’s no B plan by either the federal government or the states.”

I understand that most people may not know anything about it, and I can even understand state legislators not understanding all the details involved...but for the legislators of a state with over 460,000 people...around 5% of their entire population...likely to lose their healthcare coverage as a result to not even know that it might be a possibility??